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Utilizing Anesthesiologists, Emergency and Critical Care Physicians with Telemedicine Monitoring to Develop Intubation and Ventilation Services in an Intensive Care Unit in the Austere Medical Environment: A Case Series. Expansion of the EP/CC GAS Project

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Open Journal of Anesthesiology 2018年第6期8卷 183-197页

作者： Richard Skupski Arthur Toth Michael T. McCurdy Shane Kappler James Lantry Gerson Pyran Donald Zimmer Joseph Dynako Anne Grisoli David Zimmer John Wilson Bhavesh M. Patel Hannelisa Callisen Alyssa Chapital Lovely nathalie Colas Marc Edson Augustin nathalie edema Enzo Del Brocco Richard Frechette Mark Thompson James Corcoran Michael Mazowiecki Mark Walsh Memorial Hospital Trauma Center South Bend IN USA University of Maryland School of Medicine Baltimore MD USA Indiana University School of Medicine South Bend Campus South Bend IN USA Mayo Clinic Rochester MN USA Mayo Clinic Phoenix AZ USA Hô spital Saint Luc Port-Au-Prince Haiti Excela Health Westmoreland Hospital Greensburg PA USA Saint Joseph Regional Medical Center Mishawaka IN USA

Background: Significant resource constraints and critical care training gaps are responsible for the limited development of intensive care units (ICUs) in resource limited settings. We describe the implementation of an ICU in Haiti and report the successes and difficulties encountered throughout the process. We present a consecutive case series investigating an anesthesiologist, emergency, and critical care physician implemented endotracheal intubation and mechanical ventilation protocol in an austere environment with the assistance of telemedicine. Methods: A consecutive case series of fifteen patients admitted to an ICU at St. Luc Hospital located in Portau-Prince, Haiti, between the months of February 2012 to April 2014 is reported. Causes of respiratory failure and the clinical course are presented. Patients were followed to either death or discharge. Results: Fifteen patients (eight women and seven men) were included in the study with an average age of 37.7 years. The mean duration of ventilation was three days. Of the fifteen patients intubated, five patients (33.3%) survived and were discharged from the ICU. Of the five surviving patients, two were intubated for status epilepticus, one for status asthmaticus and one for hyperosmolar coma associated with intracerebral hemorrhage. Of the patients dying on the ventilator, four patients died from pneumonia, two from renal failure, and one from tetanus. The remaining three died from strokes and cardiac arrests. Conclusions: Mortality of mechanically ventilated patients in a resource-limited country is significant. Focused training in core critical care skills aimed at increasing the endotracheal intubation and ventilatory management capacity of local medical staff should be a priority in order to continue to develop ICUs in these austere environments. Collaborative educational and training efforts directed by anesthesiologists, emergency, and critical care physicians, and aided by telemedicine can facilitate reali

关键词： Intensive Care Unit (ICU) Critical Care Mechanical Ventilation Endotracheal Ventilation Anesthesiologist Low and Moderate-Income Country Austere Environment Telemedicine

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Analysis of mid-spatial frequency wavefront distortions from a liquid-cooled flash-lamp pumped Nd:phosphate laser amplifier

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High Power Laser Science and Engineering 2024年第1期12卷 24-29页

作者： Pierre-Marie Dalbies Sandy Cavaro Edouard Bordenave nathalie Blanchot Julien G.Moreau Jérôme Neauport CEA CESTA Le BarpFrance

Mid-spatial frequency wavefront deformation can be deleterious for the operation of high-energy laser systems. When fluid cooled high-repetition-rate amplifiers are used, the coolant flow is likely to induce such detrimental mid-spatial frequency wavefront deformations. Here, we describe the design and performance of a 90 mm × 90 mm aperture, liquid-cooled Nd:phosphate split-slab laser amplifier pumped by flash-lamps. The performance of the system is evaluated in terms of wavefront aberration and gain at repetition rates down to 1 shot per minute. The results show that this single cooled split-slab system exhibits low wavefront distortions in the medium to large period range, compatible with a focus on target, and despite the use of liquid coolant traversed by both pump and amplified wavelengths. This makes it a potential candidate for applications in large high-energy laser facilities.

关键词： flash-lamp pumping high-power laser laser cooling neodymium glass wavefront error

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Z-Score in Fetal Echocardiography–Is there Still Room for New Studies?

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Congenital Heart Disease 2024年第3期19卷 305-314页

作者： Marcio Fragoso Vieira nathalie Jeanne Bravo-Valenzuela Edward Araujo Júnior Department of Obstetrics Paulista School of MedicineFederal University of São Paulo(EPM-UNIFESP)São Paulo-SP04023-062Brazil Department of Obstetrics Federal University of Ceará(UFC)Sobral-CE60020-181Brazil Department of Pediatrics Pediatric CardiologySchool of MedicineFederal University of Rio de Janeiro(UFRJ)Rio de Janeiro-RJ21941-853Brazil

Congenital heart disease(CHD)is the most common type of birth defect,representing a significant cause of peri-natal morbidity and *** diagnosis of such anomalies is crucial for improving *** pro-tocols recommend a qualitative assessment of cardiac structures using two-dimensional ultrasound(2DUS)and color Doppler *** cases of suspected abnormalities,quantitative assessments through cardiac structure measurements and reference curves can aid in accurate *** to centiles widely employed in obste-trics,Z-scores provide more precise quantification of various cardiac structures,particularly at the extremes of the *** the development of reference curves and Z-scores has progressed over the past two decades,a lack of standardization in measurements and statistical methodology for their determination is *** reference curves requires adherence to specific recommendations to improve their *** purpose of this study is to provide a narrative review of the major studies that have generated reference values for cardiac struc-tures using 2DUS and Z-scores,to evaluate their methodology,and to provide a summary of the results.

关键词： Z-scores reference ranges fetal echocardiography

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Human Papillomavirus Within Psoriasis Plaques in a Patient With Psoriasis:A Case Report

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International Journal of Dermatology and Venereology 2024年第1期7卷 55-57页

作者： Karen P.Lema-Matehu nathalie P.Lascano-Gallegos Santiago A.Palacios-Álvarez School of Medicine Eugenio Espejo UTE UniversityQuito 170147Ecuador Department of Dermatology Centro de la PielQuito 170508Ecuador

Introduction:Psoriasis may be triggered by several factors,and its pathophysiology is related to inflammatory cellular *** herein describe a patient with psoriasis who developed warts on multiple psoriasis plaques and was successfully treated with systemic subcutaneous *** presentation:A 67-year-old man who had been diagnosed with psoriasis 14 years previously developed an outbreak of small erythematous desquamative plaques distributed symmetrically on his arms and *** spiny whitish papules had developed over his previously established psoriasis *** appearance of the papules was consistent with viral *** patient was treated with systemic methotrexate injected subcutaneously and oral folic acid,both dosed *** treatment produced good ***:A remarkable feature of this case is that psoriasis was the first diagnosis and that human papillomavirus(HPV)appeared over widespread erythematous squamous *** pathophysiology of psoriasis is related to inflammatory cellular *** authors have reported that HPV proteins may stimulate keratinocyte *** have reported that HPV infection mostly stimulates systemic interleukin 17 production;consequently,HPV infection could provide a better environment for interleukin 17 secretion and facilitate new onset of *** report indicated that methotrexate was discontinued in a patient who presented with both pathologies,although we had very good ***:Psoriasis and HPV may be pathophysiologically *** may stimulate keratinocyte proliferation and systemic interleukin 17 production,resulting in a better environment for *** methotrexate injected subcutaneously resulted in a good outcome in our patient.

关键词： human papillomavirus methotrexate psoriasis case report

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Effects of improved amino acid balance diet on lysine mammary utilization, whole body protein turnover and muscle protein breakdown on lactating sows

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Journal of Animal Science and Biotechnology 2024年第05期 2031-2043页

作者： Sai Zhang Juan C.Marini Vengai Mavangira Andrew Claude Julie Moore Mahmoud A.Mohammad nathalie L.Trottier Department of Animal Science Michigan State University State Key Laboratory of Swine and Poultry Breeding Industry Key Laboratory of Animal Nutrition and Feed Science in South ChinaMinistry of Agriculture and Rural Affairs Guangdong Provincial Key Laboratory of Animal Breeding and Nutrition Institute of Animal Science Guangdong Academy of Agricultural Sciences USDA/ARS Children's Nutrition Research Center and Pediatric Critical Care Medicine Department of Pediatrics Baylor College of Medicine Department of Large Animal Clinical Sciences Michigan State University

Background The study objective was to test the hypothesis that low crude protein(CP) diet with crystalline amino acids(CAA) supplementation improves Lys utilization efficiency for milk production and reduces protein turnover and muscle protein breakdown. Eighteen lactating multiparous Yorkshire sows were allotted to 1 of 2 isocaloric diets(10.80 MJ/kg net energy): control(CON; 19.24% CP) and reduced CP with “optimal” AA profile(OPT; 14.00% CP). Sow body weight and backfat were recorded on d 1 and 21 of lactation and piglets were weighed on d 1, 14, 18, and 21 of lactation. Between d 14 and 18, a subset of 9 sows(CON = 4, OPT = 5) was infused with a mixed solution of 3-[methyl-2H3]histidine(bolus injection) and [13C]bicarbonate(priming dose) first, then a constant 2-h [13C]bicarbonate infusion followed by a 6-h primed constant [1-13C]lysine infusion. Serial blood and milk sampling were performed to determine plasma and milk Lys enrichment, Lys oxidation rate, whole body protein turnover, and muscle protein *** Over the 21-d lactation period, compared to CON, sows fed OPT had greater litter growth rate(P < 0.05). Compared to CON, sows fed OPT had greater efficiency of Lys(P < 0.05), Lys mammary flux(P < 0.01) and whole-body protein turnover efficiency(P < 0.05). Compared to CON, sows fed OPT tended to have lower whole body protein breakdown rate(P = 0.069). Muscle protein breakdown rate did not differ between OPT and CON(P = 0.197).Conclusion Feeding an improved AA balance diet increased efficiency of Lys and reduced whole-body protein turnover and protein breakdown. These results imply that the lower maternal N retention observed in lactating sows fed improved AA balance diets in previous studies may be a result of greater partitioning of AA towards milk rather than greater body protein breakdown.

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Evaluation of the Reproduction Parameters of “Lohmann Brown” Strain Chickens Fed with Cajanus cajan Leaf Meal in the Republic of Congo

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Open Journal of Animal Sciences 2024年第3期14卷 234-248页

作者： Richard Missoko Mabeki Alexis Jonas Ognika Dora Chérita Ekou nathalie Myreille Ockoyi Parisse Akouango Laboratory of Animal Production and Biodiversity National School of Agronomy and Forestry Marien Ngouabi University Brazzaville Republic of the Congo Department of Animal Production and Health Marien Ngouabi University Brazzaville Republic of the Congo

The objective of this study was to evaluate the reproductive parameters of “Lohmann Brown” strain chickens fed on Cajanus cajan leaves and to assess the viability of the chicks after hatching. 40 hens of the “Lohmann Brown” strain fed on Cajanus cajan leaf flour laid 219 eggs divided into four batches depending on the rate of incorporation of Cajanus cajan leaf flour in the rations (0%, 5%, 10% and 15%) were trained and introduced into the incubator. Results: the incubator indicates a hatching temperature of 38˚C to 37.2˚C and relative humidity of 60% to 70%. Hatching performance shows that: The 15% batch recorded the highest fertility rate 86.95% compared to 26.88% of the control batch. The CC 15% batch recorded the highest hatching rate 36.87. The lowest rate (17.18%) was recorded in the control batch (CC 0%). The highest embryonic mortality rate was recorded in the CC 15% batch. The lowest rate in the CC 10% batch. Concerning unfertilized eggs, the highest rate is 72.20% (CC 0%), and the lowest are (12.03%;57.42% and 66.66%) recorded in CC batches. 15%, CC 5% and CC 10% respectively. For the shell mortality rate, the highest is 18.58% recorded in the CC 15% batch. The lowest shell mortality rate is 2.07%, obtained in the control batch (CC 0%);the dust mortality rate was 0% for all chicks. The study seems to indicate that the incorporation of Cajanus cajan leaf meal up to 15% into the reproduction type ration in hens does not cause any harmful effects on the reproduction performance of laying hens.

关键词： Egg Incubation Hatching Fertility Mortality Viability

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Elucidating regulatory processes of intense physical activity by multi-omics analysis

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Military Medical Research 2024年第4期11卷 479-499页

作者： Ernesto S.Nakayasu Marina A.Gritsenko Young-Mo Kim Jennifer E.Kyle Kelly G.Stratton Carrie D.Nicora nathalie Munoz Kathleen M.Navarro Daniel Claborne Yuqian Gao Karl K.Weitz Vanessa L.Paurus Kent J.Bloodsworth Kelsey A.Allen Lisa M.Bramer Fernando Montes Kathleen A.Clark Grant Tietje Justin Teeguarden Kristin E.Burnum-Johnson Biological Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Environmental and Molecular Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthWestern States DivisionDenverCO 80204USA Computational Analytics Division Pacific Northwest National LaboratoryRichlandWA 99352USA National Security Directorate Pacific Northwest National LaboratoryRichlandWA 99352USA Los Angeles County Fire Department Los AngelesCA 90063USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthRespiratory Health DivisionMorgantownWV 26505USA Environmental and Molecular Toxicology Oregon State UniversityCorvallisOR 97331USA

Background:Physiological and biochemical processes across tissues of the body are regulated in response to the high demands of intense physical activity in several occupations,such as firefighting,law enforcement,military,and sports.A better understanding of such processes can ultimately help improve human performance and prevent illnesses in the work ***:To study regulatory processes in intense physical activity simulating real-life conditions,we performed a multi-omics analysis of 3 biofluids(blood plasma,urine,and saliva)collected from 11 wildland firefighters before and after a 45 min,intense exercise *** profiles ***-exercise were compared by Student’s t-test followed by pathway analysis and comparison between the different omics ***:Our multi-omics analysis identified and quantified 3835 proteins,730 lipids and 182 metabolites combining the 3 different types of *** blood plasma analysis revealed signatures of tissue damage and acute repair response accompanied by enhanced carbon metabolism to meet energy *** urine analysis showed a strong,concomitant regulation of 6 out of 8 identified proteins from the renin-angiotensin system supporting increased excretion of catabolites,reabsorption of nutrients and maintenance of fluid *** saliva,we observed a decrease in 3 pro-inflammatory cytokines and an increase in 8 antimicrobial peptides.A systematic literature review identified 6 papers that support an altered susceptibility to respiratory ***:This study shows simultaneous regulatory signatures in biofluids indicative of homeostatic maintenance during intense physical activity with possible effects on increased infection susceptibility,suggesting that caution against respiratory diseases could benefit workers on highly physical demanding jobs.

关键词： Multi-omics analysis Intense exercise Human performance Biofluids Metabolism Immunity

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Froth flotation of scheelite – A review

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International Journal of Mining Science and Technology 2018年第3期28卷 373-384页

作者： nathalie Kupka Martin Rudolph Helmholtz Zentrum Dresden Rossendorf (HZDR) Helmholtz Institute Freiberg for Resource Technology (HIF)

Froth flotation of scheelite has regained new focus since the 2010s and research regarding floatability and reagents has made great progress over the years. The main objective was and remains the selective flotation of scheelite from other calcium-bearing minerals, in particular calcite, fluorite and apatite. Due to similar properties, most attempts have limited success or only specific application(linked to a type of ore or a location). This article aims at reviewing all general physical-chemical information on froth flotation of scheelite, including electrokinetic properties, influence of p H and already existing reagents as well as ones still under examination. It appears that chelating or mixed collectors and modified versions of sodium silicate and quebracho hold great promise for scheelite flotation, while the use of said depressants and/or promoters seems inevitable.

关键词： Scheelite Froth flotation Calcium-bearing minerals Selectivity challenges Promising reagents

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Risk Factors Associated with Unsuccessful Vaginal Birth after One Cesarean (VBAC-1) in Puerto Rico

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 888-902页

作者： Irazú Guinan Marjorie Suárez Fabiola Angulo Luis Mayol Paula Suárez Lisandris Dominicci nathalie Chang Saribel Torres Antonio Rodríguez Raymond L. Tremblay Maricarmen Colón-Díaz Department of Physiology and Pathology San Juan Bautista School of Medicine Caguas USA

Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic and associated factors influencing vaginal birth after one cesarean (VBAC-1) success focusing on variables like pre-pregnancy BMI, diabetes, hypertension, education, and smoking. Study Design and Methods: In this retrospective study, we analyzed 285 cases (81 unsuccessful VBAC-1, 204 successful VBAC-1) from San Juan City Hospital (Puerto Rico) between January 1, 2019, and December 31, 2020. We used odds ratios and model selection comparison to assess the impact of variables on successful VBAC-1, using a significance threshold of 95% CI. Model selection assessed binomial model combinations using a generalized linear approach to identify key risk factors. Results: Unsuccessful VBAC-1 (a repeat cesarean), was associated with diabetes (OR: 0.376, p = 0.086), hypertension (OR: 0.23, p = 0.006), and university-educated women (OR: 1.372, p = 0.711). High school-educated women had an OR of 3.966 (p = 0.105), while overweight women were 0.481 times more likely to have unsuccessful VBAC-1 (p = 0.041). Significant associations were not found with obesity (OR: 0.574, p = 0.122), underweight/normal (OR: 1.01, p = 0.810), or smoking (OR: 1.227, p = 0.990). Conclusion: Results revealed women with higher education levels, hypertension, or diabetes are less likely to have a successful VBAC-1. Understanding the complex interactions affecting these outcomes is aimed at establishing guidelines for healthcare professionals to conduct systematic risk/benefit assessments. This study lays a foundation for evidence-based practices and policies, offering initial insights into VBAC-1 success factors in Puerto Rico.

关键词： Diabetes Hypertension Obesity Trial of Labor Vaginal Birth after Cesarean

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Prevalence and Study of the Clonality of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Strains in Neonatology at the University Hospitals of Abidjan by the Pulsed Field Gel Electrophoresis and the Quantitative Antibiogram

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Advances in Microbiology 2024年第9期14卷 416-429页

作者： Valérie M’Bengue Gbonon Sidjè Arlette Afran Stanislas Assohoun Egomli Djeda Franck Arnaud Gnahoré Aboubakar Sylla N’Golo David Coulibaly nathalie Guessennd Assanvo Simon-Pierre N’Guetta Mireille Dosso Antibiotics Natural Substances and Anti-Infectious Resistance Surveillance Unit Pasteur Institute of Cte dIvoire Abidjan Cte dIvoire Molecular Genetics Platform Pasteur Institute of Cte dIvoire Abidjan Cte dIvoire Genetics and Species Improvement Laboratory Flix Houphout Boigny University Abidjan Cte dIvoire Mechanics and Computer Sciences Laboratory Flix Houphout Boigny University Abidjan Cte dIvoire Biology and Health Laboratory Flix Houphout Boigny University Abidjan Cte dIvoire Molecular Biology Platform Pasteur Institute of Cte dIvoire Abidjan Cte dIvoire

Background: ESBL-producing strains of Klebsiella pneumoniae, one of the main causes of nosocomial and hospital-acquired infections, are commonly associated with therapeutic impasses. Surveillance of these multidrug-resistant pathogens is a crucial tool for controlling and preventing infections. This surveillance involves the use of appropriate molecular and phenotypic typing techniques. The choice of techniques is based on criteria such as discriminatory power, intra- and inter-laboratory reproducibility, epidemiological concordance, ease of use and cost. The aim of our study was to identify clusters of Extended-Spectrum Beta-Lactamase-producing Klebsiella pneumoniae (ESBL-K. pneumoniae) strains circulating in neonatology using quantitative antibiogram (QA) and Pulsed Field Gel Electrophoresis (PFGE). Materials and Methods: This cross-sectional study included 55 K. pneumoniae strains isolated from a total of 513 samples. These various samples are taken from newborns, healthcare personnel, and the environment. K. pneumoniae identification followed standard bacteriological procedures and was confirmed using the Vitek® 2 (bioMérieux). The detection of the ESBL phenotype was performed using the synergy test. QA and PFGE were used to identify clonal relationships between the various strains isolated. Concordance between these two methods was assessed by calculating Cohen’s KAPPA coefficient and Simpson’s diversity index. Results: Among the 55 K. pneumoniae strains included in this study, 58.2% (32/55) were found to be Extended-Spectrum Beta-Lactamase (ESBL) producers. Most of these strains were isolated from neonatal samples (blood samples and rectal swabs). The quantitative antibiogram method applied to 28 out of the 32 ESBL-producing strains revealed that the isolates were grouped into 5 clusters. Pulsed Field Gel Electrophoresis performed on a total of 16 ESBL-producing strains showed the existence of four profiles. A perfect concordance was observed between the two m

关键词： Resistance-Clone-Klebsiella pneumoniae-Pulsed Field Gel Electrophoresis-Quantitative Antibiogram

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